Taking multiple medications? It’s time to ask your doctor some very important questions…

What if you took a medication for back pain that caused nausea as a side effect?

For many patients, and sometimes for doctors, the instinct may be to treat this nausea with another medication, rather than looking for an alternative to the original treatment.

This, in turn, could cause additional side effects – followed by new and potentially unnecessary prescriptions.

This worrying chain reaction is known as a “prescribing cascade”, and many Australians are caught in this difficult situation without realising it. But by asking the right questions, this can be addressed and improved.

“It’s important to ask yourself whether you’re comfortable taking your current number of medications,” says Dr Catherine Yelland, President of the Royal Australasian College of Physicians and Director of Medicine and Older Persons Service at Redcliffe Hospital, Queensland

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“It’s also important to ask whether you really need to have all symptoms treated with medication, or whether there’s an alternative you could explore.”

The key, Dr Yelland says, is to approach your time with your doctor as a partnership – not just a quick fix to a single concern, but a chance to have an open discussion about your overall health needs.

“Many patients are also taking a very significant number of vitamins and other over-the-counter medications,” says Dr. Yelland. “That can really add to their pill burden and their potential for interactions.

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“In fact, many people are on as many non-prescribed medications as they are prescribed ones. It’s important to bring those into the discussion as well.”

Even if a medication has been necessary and taken exactly as prescribed, it can often outstay its welcome.

“For example, we know that the use of sleeping pills is associated with a lot of adverse effects in older people,” says Dr Yelland.

“The advice about good sleep hygiene and getting to bed early is a better answer than using sleeping tablets. They have their place, but it shouldn’t be a long-term solution.”

While the idea of being caught in a prescribing cascade might feel daunting, there’s an easy starting point to address these concerns.

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First of all, write a list: the doses and the times that they’re to be taken. Then, using the consumer medication information – the information inside the packets – you will get a much better understanding of what you’re on and the precautions you will need to take.

This will help your doctor get a better “big picture” overview.

It can also help to see your pharmacist, who may be able to offer an evaluation of your complete range of medications and alert you to any known side effects.

With this proactivity, research and willingness to speak openly about your concerns, you will be well on your way to improved management of your health.

Choosing Wisely Australia® is helping healthcare providers and consumers start important conversations about improving the quality of healthcare by eliminating unnecessary and sometimes harmful tests, treatments, and procedures.